PMID- 30700121
OWN - NLM
STAT- MEDLINE
DCOM- 20190131
LR  - 20190318
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 101-B
IP  - 2
DP  - 2019 Feb
TI  - The influence of obesity on clinical outcomes of fixed-bearing unicompartmental 
      knee arthroplasty: a ten-year follow-up study.
PG  - 213-220
LID - 10.1302/0301-620X.101B2.BJJ-2018-0969.R2 [doi]
AB  - AIMS: The aim of this study was to assess the influence of obesity on the 
      clinical outcomes and survivorship ten years postoperatively in patients who 
      underwent a fixed-bearing unicompartmental knee arthroplasty (UKA). PATIENTS AND 
      METHODS: We prospectively followed 184 patients who underwent UKA between 2003 
      and 2007 for a minimum of ten years. A total of 142 patients with preoperative 
      body mass index (BMI) of < 30 kg/m(2) were in the control group (32 male, 110 
      female) and 42 patients with BMI of >/= 30 kg/m(2) were in the obese group (five 
      male, 37 female). Pre- and postoperative range of movement (ROM), Knee Society 
      Score (KSS), Oxford Knee Score (OKS), 36-Item Short-Form Health Survey (SF-36), 
      and survivorship were analyzed. RESULTS: Patients in the obese group underwent 
      UKA at a significantly younger mean age (56.5 years (sd 6.4)) than those in the 
      control group (62.4 years (sd 7.8); p < 0.001). There was no significant 
      difference in preoperative functional scores. However, those in the obese group 
      had a significantly lower ROM (116 degrees  (sd 15 degrees ) vs 123 degrees  (sd 17 degrees ); p = 0.003). Both 
      groups achieved significant improvement in outcome scores regardless of BMI, ten 
      years postoperatively. All patients achieved the minimal clinically important 
      difference (MCID) for OKS and KSS. Both groups also had high rates of 
      satisfaction (96.3% in the control group and 97.5% in the obese group) and the 
      fulfilment of expectations (94.9% in the control group and 95.0% in the obese 
      group). Multiple linear regression showed a clear association between obesity and 
      a lower OKS two years postoperatively and Knee Society Function Score (KSFS) ten 
      years postoperatively. After applying propensity matching, obese patients had a 
      significantly lower KSFS, OKS, and physical component score (PCS) ten years 
      postoperatively. Seven patients underwent revision to total knee arthroplasty 
      (TKA), two in the control group and five in the obese group, resulting in a mean 
      rate of survival at ten years of 98.6% and 88.1%, respectively (p = 0.012). 
      CONCLUSION: Both groups had significant improvements in functional and 
      quality-of-life scores postoperatively. However, obesity was a significant 
      predictor of poorer improvement in clinical outcome and an increased rate of 
      revision ten years postoperatively.
FAU - Xu, S
AU  - Xu S
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
FAU - Lim, W-A J
AU  - Lim WJ
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
FAU - Chen, J Y
AU  - Chen JY
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
FAU - Lo, N N
AU  - Lo NN
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
FAU - Chia, S-L
AU  - Chia SL
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
FAU - Tay, D K J
AU  - Tay DKJ
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
FAU - Hao, Y
AU  - Hao Y
AD  - Health Service Research Unit, Singapore General Hospital, Singapore.
FAU - Yeo, S J
AU  - Yeo SJ
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Bone Joint J
JT  - The bone & joint journal
JID - 101599229
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - *Arthroplasty, Replacement, Knee/instrumentation
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - *Knee Prosthesis
MH  - Male
MH  - Middle Aged
MH  - Obesity/*complications
MH  - Osteoarthritis, Knee/complications/*surgery
MH  - Patient Satisfaction
MH  - Prospective Studies
MH  - Prosthesis Design
MH  - Prosthesis Failure
MH  - Quality of Life
MH  - Range of Motion, Articular
MH  - Recovery of Function
MH  - Reoperation
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Functional outcome
OT  - Obesity
OT  - Outcome
OT  - Quality of life
OT  - Revision
OT  - Survivorship
OT  - Unicompartmental knee arthroplasty
EDAT- 2019/02/01 06:00
MHDA- 2019/02/01 06:01
CRDT- 2019/02/01 06:00
PHST- 2019/02/01 06:00 [entrez]
PHST- 2019/02/01 06:00 [pubmed]
PHST- 2019/02/01 06:01 [medline]
AID - 10.1302/0301-620X.101B2.BJJ-2018-0969.R2 [doi]
PST - ppublish
SO  - Bone Joint J. 2019 Feb;101-B(2):213-220. doi: 
      10.1302/0301-620X.101B2.BJJ-2018-0969.R2.